23 April 2018 - Cancer Centre, Old QE Hospital

From 10 to 20 April, Deb completed her first course of the PCV chemotherapy. This was not as bad as expected but she was still sick a few times and very tired. This visit we saw Dr Sanghera and Claire, CNS. It was a short meeting for Dr Sanghera to review how Deb had got on. He said that she should not have to suffer being sick on this treatment and should take more anti sickness medication next time. Next visit to the hospital is on May 21 to see Dr Sanghera before Deb starts her next course of chemo on the 22nd.

10 April 2018 - Ward 621, Out-patients Oncology/Haematology Unit, QE Hospital

Deb having her Vincristine chemotherapy 

Visit to start Deb's chemotherapy. We got to the hospital at 1.15 for a 1.30 appointment. OK we then waited an hour or so but that's fine; there were a lot of people having chemotherapy. Deb was then called in to the unit and is prepared by the nurse - lots of questions, hands warmed up and cannula inserted. We spoke about what happened yesterday and that Deb is expecting to leave the hospital with some antibiotics. This worried the nurse who wandered off to see Mark the registrar who was consulted yesterday. They now decide to take more bloods from Deb (which were the same as yesterday) and decide that Deb needs a chest x ray. So we have to go down to the ground floor imaging department and wait 45 minutes for an x ray (the results are fine). By the time we get back to the chemo unit it is 4.30 and chemo can start. 

2 things annoyed me about this visit:

1) I know they have to be cautious but the registrar made a decision based on the information he had yesterday. Nothing has changed but he now decides he needs a chest x ray. Why couldn't he just make a decision and stick by it. He did look about 21 and had a distinct lack of facial hair.

2) I expected the nurses to be more focused on what they were doing The bag containing Deb's chemotherapy had a notice on it saying 'Fatal if not taken intravenously'. Despite this the nurse wandered off, had chats to friends, went off to do other jobs. I know they do this all day and every day but these are dangerous drugs. They sent us home with two more lots of chemotherapy. The nurse was decidedly woolly as to when to take everything - anti-sickness, chemotherapy, antibiotics, laxatives, more anti sickness. Come on NHS these drugs are cytotoxic.

9 April 2018 - Ward 621 Out-patients Oncology/Haematology Unit, QE Hospital

View from 6th floor QE Hospital

The visit today was for Deb to have a 'new patient' assessment prior to starting chemotherapy. Over the past few weeks, well actually since the start of the year, Deb has not been very well. She has had a cough which keeps her awake at night, has been very tired (perhaps because of the not sleeping with the cough), weak and her balance has not been good. Last week we went to the GP's surgery 3 times because they were worried Deb had some sort of infection. The GP thought that Deb should not start her chemotherapy. However when I rang the hospital they said Deb should come in for the assessment and a decision would be made then as to whether chemo should start.

We were seen by a chemotherapy nurse Megan. She told Deb what the PCV treatment involved and the possible side effects (that took about half an hour and included risk of infection, anaemia, feeling sick, tiredness, hair loss etc etc.). She took blood from Deb which was then tested. The test results were ok. Throughout the meeting Deb was coughing. Megan went to consult a doctor as to whether Deb should start the chemo the next day. The doctor said she should but he would prescribe some antibiotics which Deb should take if her temperature went up above 38 or she showed any other signs of infection (diarrhoea, vomiting etc.) So the PCV chemotherapy starts tomorrow. Each cycle lasts 42 days and Deb has been booked in for 6 cycles. The dates are shown below:

Date	Start Time	Treatment
Mon 09 Apr 18	15:00	PCV attenuated (v6)
Tue 10 Apr 18	13:30	PCV attenuated (v6)
Tue 22 May 18	14:00	PCV attenuated (v6)
Tue 03 Jul 18	12:45	PCV attenuated (v6)
Tue 14 Aug 18	12:00	PCV attenuated (v6)
Tue 25 Sep 18	12:00	PCV attenuated (v6)
Tue 06 Nov 18	12:00	PCV attenuated (v6)

To put it mildly, Deb is not looking forward to this treatment. It is not helped by the fact that she already feels unwell even before anything has started. But hopefully after 9 months without any treatment, the chemo will do something to slow tumour growth.